Milking it? | Aidan Cook

Nestlé is one of those companies that everyone loves to hate. Like McDonald’s or Coca-Cola, it has become a scapegoat for the perceived failings of capitalism. Aidan Cook finds out whether the criticism is justified.

In 1977, a boycott of Nestlé was started in protest of the company’s marketing of infant formula in Third World countries. Infant formula, or breast milk substitute, was the firm’s original product and brainchild of founder Henri Nestlé (who created it to feed his neighbour’s starving baby – two can play at the emotions game). By the 1970s, allegations were made that Nestlé was promoting itself in a way that forced mothers to buy previously unnecessary products. Hospitals were giving infant formula, provided free by Nestlé, to babies who could not then return to breastfeeding. What’s more, mothers could not afford the formula once the hospital stopped providing it free of charge. The damage, it was argued, was not only economic but health-related too. The infant formula was mixed using contaminated water, or was over-diluted to make it go further, leaving babies under-nourished and vulnerable to water-borne illnesses such as diarrhoea. Mothers were being misinformed and left thinking that infant formula was better than breast milk.

The boycott seeks to force Nestlé into abiding by the World Health Organisation’s International Code of Marketing of Breast-Milk Substitute, which organisers of the boycott claim Nestlé is systematically violating. Although Nestlé is by no means the only manufacturer to allegedly violate the code, it is singled out for boycott because of the number of allegations against it and because of its size. The number of markets Nestlé is present in mean there are more products that can be boycotted, increasing the campaign’s visibility. The aim is to keep the issue in the public eye in order to achieve more strict marketing standards and improved education.

The problem lies not in any promotion, alleged or real, carried out by Nestlé, but in the inadequate promotion of exclusive breastfeeding in general. This is where the main concern with contaminated water lies: not when used in infant formula but on its own as a supplement to breast milk. The overwhelming majority of babies are given water; only a tiny minority are fed infant formula. Indeed, more of the product is used in Belgium than in the whole of sub-Saharan Africa.

Campaigners also argue that Nestlé and other companies aggressively promote their products to health workers to persuade them to recommend their products unnecessarily. The marketing of specific products, however, is widespread in all sectors of healthcare. Manufacturers of treatments for all kinds of illnesses take hospital staff out for meals, give doctors gifts and use many other means to promote their product over that of their competitors. With infant formula, however, an assumption seems to be made that companies are out not to promote their products relative to others on the market, but in absolute terms. Manufacturers of insulin who promote their products to doctors are not accused of suggesting that it should be given to all patients, even non-diabetics. A double standard seems to be at work. A doctor should know that breast milk is to be preferred over any substitute if at all possible. Nothing Nestlé gives out is in exchange for increased sales but is in fact given to all doctors, even those who actively discourage breast milk substitutes. To blame the incompetence of medical professionals on a food manufacturer seems exceedingly harsh.

Many of the accusations put to Nestlé are also illustrated by statistics used in a deceitful way. Claims put forward may be both true and relevant but do not tell the whole story. For example, Baby Milk Action, who coordinate the boycott, state in anti-Nestlé material that “every day more than 4,000 babies die because they’re not breastfed. That’s not conjecture, it’s UNICEF fact.” Indeed, UNICEF does claim that 1.5 million children a year die because they are inadequately breastfed but what has this got to do with Nestlé? As far as this statistic shows, Nestlé products are not necessarily responsible for any of these deaths. Indeed, Nestlé products are infinitely safer than many of the other possible substitutes available. And how many of these children, for one reason or another, cannot be breastfed? The World Health Organisation (WHO), however, whose figures UNICEF used, made their position perfectly clear as far back as 1992: the “WHO has made no statement quantifying the impact on either morbidity or mortality of infants being fed on bona fide infant formula, i.e. breast-milk substitutes manufactured in accordance with the relevant standards of the Codex Alimentarius. In contrast, WHO has estimated that [this] number of infant deaths…could be averted annually through effective breastfeeding promotion, and this irrespective of the breast milk substitutes used to feed them.” In a boycott concerned with marketing practices, to bend statistics in this way seems at best hypocritical.

Following the start of the boycott, Nestlé consulted widely to find the best solution to the problem, with wide-ranging results. Since 1982, the company has voluntarily followed the WHO’s International Code of Marketing of Breast-Milk Substitute in all developing countries. Infant formula is not advertised to the general public, and has not been since the 1970s. It is only provided free of charge to hospitals in exceptionally rare circumstances, for example at the request of governments following extreme natural disasters. Even free samples for healthcare professionals are limited to just two in their entire lifetime. There is no direct contact between Nestlé and mothers: that is left entirely to trained and independent healthcare professionals.

Mistakes are made. Nestlé admit that parts of their company are flawed, and continue to investigate thoroughly any accusation of breaches to the guidelines. And there are certainly plenty of organisations willing to provide such accusations, the International Baby Food Action Network (IBFAN) and Save the Children being just two. Where, though, does the boycott fit into all of this? In this era of increasingly socially and ethically responsible business it does not seem necessary. Surely, rather than fighting against Nestlé, it would be better to work with them. Indeed, far from being the source of all evil, Nestlé is arguably a force for good. While not preferable to breast milk, infant formula os far superior to many other possible substitutes. Without it, many babies cows’s milk or herbal tea with horrendous consequences. Indeed, infant formula is the only product recognised by the WHO as being a complete nutritional substitute for breast milk. Thanks to disease, famine and war, there is already a vital need for this and similar products that Nestlé provides.

Improved breastfeeding rates could prevent 13% of under-5 deaths in the 42 countries where most occur. Appropriate introduction of complementary foods could prevent 6% of under-5 deaths. One of the largest providers of such complementary products is Nestlé. Once again, this illustrates the good that Nestlé products are doing in the developing world, and indeed in developed countries as well.

Nestlé’s infant formula is a vital product without which hundreds of thousands of babies would remain malnourished or starving. Their complementary products for older children provide vital nutritional supplements to their usual diet. To be sure, Nestlé has its faults, but to me at least, it doesn’t seem like a company in need of boycotting. Instead, why don’t we work with Nestlé to ensure that things continue to improve?

If you should remain sceptical that Nestlé could be anything other than profit-driven, then look at it this way. The bottom line is that dead babies don’t consume, so Nestlé doesn’t like them any more than you do.